How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,000.00 Median $2,041.74 Typical High $7,762.47 | Facility | None | $1,000.00 | $2,041.74 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $2,041.74 Typical High $2,041.74 | Professional | None | $1,412.54 | $2,041.74 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,398.83 Typical High $3,388.44 | Facility | None | $602.56 | $2,398.83 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,819.70 Typical High $2,691.53 | Professional | None | $1,513.56 | $1,819.70 | $2,691.53 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $446.68 Typical High $2,238.72 | Professional | None | $33.11 | $446.68 | $2,238.72 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $2,238.72 Typical High $3,467.37 | Facility | None | $602.56 | $2,238.72 | $3,467.37 |
Providence Setting Professional Modifier None Typical Low $1,513.56 Median $1,819.70 Typical High $2,884.03 | Professional | None | $1,513.56 | $1,819.70 | $2,884.03 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,235.94 Typical High $10,471.29 | Facility | None | $1,230.27 | $3,235.94 | $10,471.29 |
United Setting Professional Modifier None Typical Low $1,412.54 Median $2,137.96 Typical High $2,818.38 | Professional | None | $1,412.54 | $2,137.96 | $2,818.38 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $707.95 Median $1,023.29 Typical High $1,023.29 | Professional | 52 · Reduced service | $707.95 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $407.38 Typical High $407.38 | Professional | 53 · Discontinued | $281.84 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,513.56 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,071.52 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $302.00 Typical High $302.00 | Professional | 55 · Aftercare only | $213.80 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $204.17 Typical High $204.17 | Professional | 56 · Pre-op care only | $141.25 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,412.54 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,412.54 | $1,412.54 |
Where New Mexico sits
The same service costs 16.2 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
New Mexico· 25th of 51
$2,042
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.